Allergy Skin Research Articles

Cost of Serum Versus Skin Allergy Testing Among Medicare Fee-for-Service Beneficiaries in the United States

Background: Testing for allergic sensitization can be achieved similarly via skin or serum specific immunoglobulin E (sIgE) testing, although the costs of each method differ. Objective: This study compared cost and utilization of allergy testing utilizing skin vs sIgE testing and whether equal access (parity) to both testing methods affects overall allergy testing costs among Medicare fee-for-service beneficiaries in the United States. Methods: Allergy test utilization and payment data were analyzed using 100% 2019 Medicare fee-for-service claims data. Beneficiaries with any sIgE test, skin prick test, or intradermal skin test associated with ICD-10 codes of allergic rhinitis, asthma, and food allergy were included. Aggregate and per-beneficiary testing cost, number of allergens tested, and number of allergy-related specialist visits incurred were estimated by the testing patterns of sIgE only, skin prick only, intradermal only, skin prick and intradermal, and sIgE plus prick and/or intradermal. Medicare Administrative Contractors (MACs) with parity for all allergy tests and those which restricted sIgE testing were compared. Multivariate linear regression was performed on the association between testing patterns and each cost and utilization measure, controlling for parity, age, sex, race/ethnicity, and dual-eligible status. Results: We analyzed 270 831 patients and 327 263 allergy-related claims. Total payment for all allergy tests was $71 380 866, including $15 903 954 for sIgE tests, $42 223 930 for skin prick tests, and $13 252 982 for intradermal tests. Beneficiaries receiving sIgE tests had only 1.8 fewer allergist visits than those with skin prick tests only (0.8 vs 2.6). Cost of testing per beneficiary was also lower in sIgE testing only compared with skin prick tests only ($161 vs $247). Multivariable regression results showed per-beneficiary payments for allergy testing were on average $22 lower in MACs with parity compared with MACs without parity. Discussion: Serum specific IgE testing is associated with lower costs and fewer allergy specialist visits compared with skin testing. Insurance coverage with parity toward sIgE and skin testing is associated with lower overall costs of allergy testing. Conclusion: Among Medicare fee-for-service beneficiaries in the United States, sIgE testing may be more cost effective compared with skin testing in the management of allergic disease.

Cost of Serum Versus Skin Allergy Testing Among Medicare Fee-for-Service Beneficiaries in the United States.

Background: Testing for allergic sensitization can be achieved similarly via skin or serum specific immunoglobulin E (sIgE) testing, although the costs of each method differ. Objective: This study compared cost and utilization of allergy testing utilizing skin vs sIgE testing and whether equal access (parity) to both testing methods affects overall allergy testing costs among Medicare fee-for-service beneficiaries in the United States. Methods: Allergy test utilization and payment data were analyzed using 100% 2019 Medicare fee-for-service claims data. Beneficiaries with any sIgE test, skin prick test, or intradermal skin test associated with ICD-10 codes of allergic rhinitis, asthma, and food allergy were included. Aggregate and per-beneficiary testing cost, number of allergens tested, and number of allergy-related specialist visits incurred were estimated by the testing patterns of sIgE only, skin prick only, intradermal only, skin prick and intradermal, and sIgE plus prick and/or intradermal. Medicare Administrative Contractors (MACs) with parity for all allergy tests and those which restricted sIgE testing were compared. Multivariate linear regression was performed on the association between testing patterns and each cost and utilization measure, controlling for parity, age, sex, race/ethnicity, and dual-eligible status. Results: We analyzed 270 831 patients and 327 263 allergy-related claims. Total payment for all allergy tests was $71 380 866, including $15 903 954 for sIgE tests, $42 223 930 for skin prick tests, and $13 252 982 for intradermal tests. Beneficiaries receiving sIgE tests had only 1.8 fewer allergist visits than those with skin prick tests only (0.8 vs 2.6). Cost of testing per beneficiary was also lower in sIgE testing only compared with skin prick tests only ($161 vs $247). Multivariable regression results showed per-beneficiary payments for allergy testing were on average $22 lower in MACs with parity compared with MACs without parity. Discussion: Serum specific IgE testing is associated with lower costs and fewer allergy specialist visits compared with skin testing. Insurance coverage with parity toward sIgE and skin testing is associated with lower overall costs of allergy testing. Conclusion: Among Medicare fee-for-service beneficiaries in the United States, sIgE testing may be more cost effective compared with skin testing in the management of allergic disease.

Zn2+ @Polyvinylpyrrolidone and Urushiol Preparation of Nanofibrous Membranes and Their Synergistic Effect.

In this study, lacquer is gathered from a lacquer tree and rotary evaporation is used to remove impurities to obtain urushiol. Next, 10mL of anhydrous ethanol serves as the solvent for blending polyvinylpyrrolidone (PVP) at a specified content (0.7g and 0.2-0.7g urushiol) to form an electrospinning solution. Electrospinning is carried out with a voltage of 18kV to prepare PVP/urushiol nanofibrous membranes. At a ratio of 7/4, the PVP/urushiol nanofibrous membranes are not eroded in 98% sulfuric acid and these membranes also demonstrate a 50-60% antibacterial effect against Staphylococcus aureus and Escherichia coli. Moreover, the antibacterial effect can be boosted to 98% with the incorporation of zinc ions. The results indicate that anhydrous ethanol can remove the sensitization of urushiol from PVP/urushiol membranes. Furthermore, animal test results indicate that when rats are in contact with PVP/urushiol anhydrous ethanol for 48h, their skins are free from dark brown skin allergy. The presence of PVP eliminates the sensitization of urushiol, and the nanofibrous membranes demonstrate low toxicity. Hence, urushiol is the only natural material that enables PVP to withstand 98% sulfuric acid as well as acquire hydrolyzability, thereby qualify PVP as a medical material.

Epidemiological, Clinical and Laboratory Features of Strongyloidiasis in 69 Attendees at a French Outpatient Clinic.

The present retrospective study analyzed the characteristics of strongyloidiasis in patients who were diagnosed at the Outpatient Clinic of the Department of Parasitology-Mycology, Toulouse, France. Sixty-nine file records were included in the study on the basis of a positive stool examination that used Baermann's method. The prominent epidemiological findings were the presence of former immigrants from Italy or Portugal, veterans from the 1st Indochina war, and autochthonous cases. Almost 1/4 of the patients were asymptomatic. Manifestations of skin allergy were the main clinical feature. Blood eosinophilia was present in 76.8% of the patients, and serum total IgE was ≥150 kIU/L in 79.7%. Immunodiagnosis was achieved from 1990 to 2001 by indirect immunofluorescence (IFAT) that was then replaced with ELISA, both methods using Strongyloides ratti filariform larvae. ELISA was found to be similar to IFAT in terms of specificity but exhibited a greater sensitivity. Patients were primarily treated with albendazole or ivermectin beginning in 1993. Forty-eight patients attended the follow-up consultation. Kinetics of the clinical picture and blood eosinophilia were found to be the most convenient parameters to assess the efficacy of anthelmintic therapy. In conclusion, strongyloidiasis remains a neglected disease in Southwestern France. The resolution of clinical features along with the kinetics of eosinophilia appeared to be the most appropriate parameters to check during the posttreatment follow-up.

COVID-19 patients treated with convalescent plasma.

In Norway, treatment with COVID-19 convalescent plasma has been given through the NORPLASMA project. The treatment was initially offered to critically ill patients after an individual assessment, but from December 2020, the indication was limited to critically ill, immunocompromised patients. In this article we describe clinical characteristics, comorbidity and mortality in patients who received convalescent plasma in these two periods. From 22April 2020 to 30March 2022, a total of 79 patients were included in the observational studies NORPLASMA MONITOR and the Norwegian SARS-CoV-2 study. The patients had received a total of 193 units of convalescent plasma at 15 Norwegian hospitals/nursing homes; 62 in South-Eastern Norway Regional Health Authority, 8 in Western Norway Regional Health Authority and 9 in Central Norway Regional Health Authority. Information on immune status, comorbidity and course of infection was retrieved from the patient records after informed written consent was obtained. Of 79 patients with a median age of 65 years (interquartile range 51-⁠73) who were treated with convalescent plasma, 31 (39%) died during hospitalisation. A total of 59 patients were immunocompromised, and of these, 20 died in hospital compared to 11 of 20 who were assumed to be immunocompetent. Median number of comorbidities was 2 (interquartile range 1-4). The patients received a median of two plasma units (min.-max. 1-21). Two of the patients developed mild allergic skin reactions. Convalescent plasma was well tolerated by patients with COVID-19. Immunocompromised patients may have benefitted from the treatment, with lower mortality than for those assumed to be immunocompetent.

A Promising Approach to Treat Psoriasis: Inhibiting Cytochrome P450 3A4 Metabolism to Enhance Desoximetasone Therapy.

(1) Background: Human keratinocytes and murine skin express various cytochrome P450 enzymes. These include cytochrome P450 3A4, which may participate in the metabolism of cytochrome P450 3A4 substrate drugs. Desoximetasone, a topical corticosteroid and cytochrome P450 3A4 substrate, is used to treat skin conditions such as skin allergies, atopic dermatitis, and psoriasis. In this study, we aimed to investigate the anti-psoriatic effect of a low dose of desoximetasone by inhibiting cytochrome P450 3A4 metabolism in the epidermis. (2) Methods: Psoriasis-like skin was induced in BALB/c mice via the topical administration of imiquimod. The mice were then topically treated with 0.01-0.05% desoximetasone loaded into a cytochrome P450 3A4 enzyme inhibitor excipient base emollient microemulsion, 0.25% commercial desoximetasone ointment, or 0.5 mg/gm clobetasol ointment. (3) Results: The topical application of 0.05% desoximetasone loaded into a cytochrome P450 3A4 enzyme inhibitor excipient base emollient formulation restored the imiquimod-induced skin barrier disruption and resulted in fewer severe clinical and pathological features compared with the treatments with 0.25% commercial desoximetasone ointment and 0.5 mg/gm clobetasol ointment. (4) Conclusions: The cytochrome P450 3A4 enzyme inhibitor excipient base emollient formulation improved and prolonged the therapeutic effect of cytochrome P450 3A4 substrate drugs and may be a promising approach for psoriasis treatment.

Analysis of Intestinal Microbiota and Metabolic Pathways before and after a 2-Month-Long Hydrolyzed Fish and Rice Starch Hypoallergenic Diet Trial in Pruritic Dogs.

Intestinal microbiota alterations were described in allergic individuals and may improve with diets. Farmina Ultra Hypo (FUH), a hydrolyzed fish/rice starch hypoallergenic diet, is able to improve clinical signs in allergic dogs. Study objectives were to determine microbiota differences in allergic dogs before and after feeding with FUH for eight weeks. Forty skin allergic dogs were evaluated clinically before and after the diet. Unresponsive dogs were classified as canine atopic dermatitis (CAD); responsive dogs relapsing after challenge with previous foods were classified as being food reactive (AFR), and those not relapsing as doubtful (D). Sequencing of feces collected pre- and post-diet was performed, with comparisons between and within groups, pre- and post-diet, and correlations to possible altered metabolic pathways were sought. Microbiota in all dogs was dominated by Bacteroidota, Fusobacteriota, Firmicutes and Proteobacteria, albeit with large interindividual variations and with some prevalence changes after the diet. In general, bacteria producing short-chain fatty acids were increased in all samples. CAD dogs showed pre-and post-diet microbiota patterns different from the other two groups. Bacteria taxa were enriched post-diet only in the AFR group. Changes in metabolic pathways were observed mainly in the CAD group. FUH may be able to improve intestinal microbiota and thus clinical signs of skin allergy.

Safety data sheets as an information pathway on hazards of occupationally used cleaning agents

To investigate consistency and accessibility of asthma and skin allergy hazard information in safety data sheets (SDSs) for cleaning agents on the Swedish market, we compiled a database of 504 SDSs and 351 therein declared ingredients. Labelling of products was compared to that of ingredients according to harmonised classification. For each ingredient, also notified classification and three additional sources on sensitising properties were compared. Product labelling most frequently indicated corrosion and irritation hazards. Only 3% of products were labelled as skin sensitisers and none as asthmagens. According to harmonised classification, 9% of products contained skin sensitisers, using other information sources increased the number to 46%. While 2% of products contained respiratory sensitisers according to harmonised classification, the number increased to 17% when using other information sources. Furthermore, sensitisers were declared across several sections of the SDSs, hampering easy access of such information. In conclusion, there are inconsistencies in hazard identification of cleaning agents and their ingredients. Hence, SDSs may not altogether fulfil its hazard information role. Improved criteria for identifying sensitisers and respiratory irritants are warranted. Additionally, we argue that all ingredients should be listed in section 3 regardless of concentration, to facilitate access of information about sensitising properties.

Involvement of type-1 pathway in phototoxicity of benzo[ghi]perylenean ingredient of tattoo ink at ambient exposure of UVR and sunlight.

Tattooing on different parts of the body is a very common fashion trend in all sections of society globally. Skin allergies and other related skin diseases are very common among tattoo users. Benzo[ghi]perylene (BP) is a PAH and an important component of tattoo ink that showed prominent absorption under ultraviolet radiation (UVR) region. Therefore, to provide safety to the skin, a thorough safety study of BP exposed under UVR and Sunlight is very essential to understand their hazardous impact on the skin. BP showed a strong absorption of UVA and UVB radiation of sunlight. It is photolabile and degraded under UVA, UVB, and Sunlight in progressing order of time (1-4 h) without generating any novel photoproducts. Further, BP showed a specific generation of O2.- and OH radicals via activation of type I photodynamic reaction under exposure to UVA, UVB and Sunlight. Photocytotoxicity results illustrated concentration-dependent cell viability reduction in all exposure conditions of UVA, UVB, and Sunlight, respectively. Fluorescent probes (2',7'-dichlorofluorescein diacetate and dihydroethidium) for intracellular reactive oxygen species (ROS) generation supported the involvement of ROS in the phototoxicity of BP in the HaCaT cell line. Hoechst staining showed significant genomic insult induced by BP under UVA and UVB. Photoexcited BP promoted cell cycle arrest in the G1 phase and induced apoptosis confirmed via acridine orange/ethidium bromide staining. The findings of gene expression also supported apoptotic cell death in photoexcited BP via an increase in the level of pro-apoptotic gene (Bax) and a decrease in the level of anti-apoptotic gene (Bcl-2). The aforementioned finding indicates that tattoo users should avoid using BP since it can cause skin damage/diseases if they are exposed to UVR or Sunlight while tattooing on the body.

Identification of Work-related Diseases in Small-scale Fishermen in Batam Island, Indonesia

Background: Small-scale fishermen's work activities are carried out in a marine environment which has the potential to cause certain work-related diseases. AIMS: This study aims to identify the incidence of work-related diseases among small-scale fishermen in Batam Island, Indonesia. Methods: This study used both quantitative and qualitative approaches involving 119 small-scale fishermen. Data was collected through questionnaires, observations, documentation, interviews, focus group discussions, and secondary data collection. Results: The results showed that all small-scale fishermen complained of diseases caused by threats in the chemical, physical, biological, psychological, and ergonomic factors group. Conclusion: Most fishermen complained about colds, fever, stings, blisters, skin allergies, and eye disorders/myopia. Most complaints were obtained from small-scale fishermen over 40 years old, especially the ones with smoking habits. Identification of work-related diseases was required to prevent and control the health problems that could endanger small-scale fishermen’s health and productivity.

A CASE REPORT ON AYURVEDIC APPROACH OF VIPADIKA KUSTHA

India is a developing country, here to meet both ends people are involved in many unorganised sectors works. Construction work that includes the use of cement is very common among them. cement is a very known factor for skin irritation and allergy if in prolonged use. It usually affects the palm and sole in the body of the worker. This type of presentation of cracks in hands and feet can be considered in Vipadika Kustha as described by Charaka Samhita. In the present case report a patient with complaints of dryness and cracking of palm and soles associated with pain in the past 8 years was treated on the Kustha line of treatment including Sodhana and Shaman Chikitsa. These treatments help the patient in a significant way.

The state and consideration for skin test of β-lactam antibiotics in pediatrics.

β-lactam antibiotics are the most frequently used drugs and the most common drugs that cause allergic reactions in pediatrics. The occurrence of some allergic reactions can be predicted by skin testing, especially severe adverse reactions such as anaphylactic shock. Thus, penicillin and cephalosporin skin tests are widely used to predict allergic reactions before medication in pediatrics. However, false-positive results from skin tests were more often encountered in pediatrics than in adults. In fact, many children labeled as allergic to β-lactam are not allergic to the antibiotic, leading to the use of alternative antibiotics, which are less effective and more toxic, and the increase of antibiotic resistance. There has been controversy over whether β-lactam antibiotics should be tested for skin allergies before application in children. Based on the great controversy in the implementation of β-lactam antibiotic skin tests, especially the controversial cephalosporin skin tests in pediatrics, the mechanism and reasons of anaphylaxis to β-lactam antibiotics, the significance of β-lactam antibiotic skin tests, the current state of β-lactam antibiotic skin tests at home and abroad, and the problems of domestic and international skin tests were analyzed to determine a unified standard of β-lactam antibiotic skin tests in pediatrics to prevent and decrease adverse drug reactions, avoid waste of drugs, and a large amount of manpower and material resource consumption.

Microneedle-assisted transdermal delivery of perfluorotripropylamine-based oxygenated emulsion gel loaded with 5-aminolevulinic acid for enhanced photodynamic therapy of cutaneous squamous cell carcinoma

Topical photodynamic therapy (TPDT) is a clinical treatment for cutaneous squamous cell carcinoma (CSCC). However, the therapeutic efficacy of TPDT for CSCC is significantly weakened by hypoxia, which is caused by the oxygen-poor environment of the skin and CSCC and by the high oxygen consumption of TPDT itself. To overcome these problems, we developed a topically applied perfluorotripropylamine-based oxygenated emulsion gel loaded with the photosensitizer 5-ALA (5-ALA-PBOEG) by a simple ultrasound-assisted emulsion method. With the aid of the microneedle roller, 5-ALA-PBOEG dramatically increased the accumulation of 5-ALA in the epidermis and the dermis, as well as throughout the dermis; a total of 67.6% ± 9.97% of the applied dose penetrated into and through the dermis, which is 19.1±3.2-fold that of the 5-ALA-PBOEG without microneedle treatment group, and 16.9±0.3-fold that of the aminolevulinic acid hydrochloride topical powder treatment group (p<0.001). Meanwhile, PBOEG enhanced the singlet oxygen yield of 5-ALA-induced protoporphyrin IX. The results of in vivo antitumor activity in human epidermoid carcinoma (A431) bearing mice showed that by increasing the oxygen content in tumor tissues, the developed 5-ALA-PBOEG plus microneedle treatment and laser irradiation showed better tumor growth inhibition than the respective control formulations. In addition, the results of safety studies, including the multiple-dose skin irritation study, allergy tests, and skin H&E staining, demonstrated the safety of 5-ALA-PBOEG plus microneedle treatment. In conclusion, the 5-ALA-PBOEG plus microneedle treatment shows great potential in the fight against CSCC and other skin cancers.

Diagnosis and Prevention of Scabies in Low Mobility Patients with Cognitive Impairment

Scabies is an infectious skin disease caused by the human-specific ectoparasite Sarcoptes scabiei var. hominis. Despite the comprehensive study of scabies, the problem of its timely diagnosis in low-mobility patients with neurological and cognitive impairments remains relevant all over the world. Simultaneous administration of a large number of medications to patients with limited mobility may mask the clinical manifestations of scabies and mistakenly attribute itching to manifestations of skin allergic reactions or other dermatoses. The authors observed patient K., who was admitted in FCBRN of FMBA of Russia from 14.11.2022 to 15.11.2022. Clinical diagnosis upon admission: I69.3. The consequences of a stroke. Early recovery period of ischemic stroke in the basin of the left middle cerebral artery from 09.08.2022, atherothrombotic subtype according to TOAST criteria. Right-sided hemiparesis. Gross aphasia. Violation of the pelvic organs function. RMS 5. Comorbid diseases: arterial hypertension, controlled, the risk of CVE 4 (very high). The target blood pressure is less than 135/85 mmHg. Occlusion of the left anterior cerebral artery, middle cerebral artery. Toxic-allergic dermatitis (medicinal) in the acute phase. Based on a set of clinical data and laboratory detection of the pathogen, patient K. was diagnosed with B86 — scabies. Even though the patient was under medical supervision at the ambulatory step, scabies was not diagnosed timely. Late diagnosis of scabies leads to the spread of the disease and an unfavorable epidemiological situation.

Microbial Surfactants to the Rescue

Microbial Surfactants to the Rescue

Neonatal Seizure Detection Using a Wearable Multi-Sensor System.

Neonatal seizure is an important clinical symptom of brain dysfunction, which is more common in infancy than in childhood. At present, video electroencephalogram (VEEG) technology is widely used in clinical practice. However, video electroencephalogram technology has several disadvantages. For example, the wires connecting the medical instruments may interfere with the infant's movement and the gel patch electrode or disk electrode commonly used to monitor EEG may cause skin allergies or even tears. For the above reasons, we developed a wearable multi-sensor platform for newborns to collect physiological and movement signals. In this study, we designed a second-generation multi-sensor platform and developed an automatic detection algorithm for neonatal seizures based on ECG, respiration and acceleration. Data for 38 neonates were recorded at the Children's Hospital of Fudan University in Shanghai. The total recording time was approximately 300 h. Four of the patients had seizures during data collection. The total recording time for the four patients was approximately 34 h, with 30 seizure episodes recorded. These data were evaluated by the algorithm. To evaluate the effectiveness of combining ECG, respiration and movement, we compared the performance of three types of seizure detectors. The first detector included features from ECG, respiration and acceleration records; the second detector incorporated features based on respiratory movement from respiration and acceleration records; and the third detector used only ECG-based features from ECG records. Our study illustrated that, compared with the detector utilizing individual modal features, multi-modal feature detectors could achieve favorable overall performance, reduce false alarm rates and give higher F-measures.

Cessante Causa, Cessat Effectus : Cure is only Possible by Hering’s Law of Cure and with Annihilation of Existing Miasmatic Manifestation

Skin diseases in homoeopathy are regarded as Mother of all chronic diseases, so it is not neglected and considered as Causa prima - Hahnemann’s psoric manifestation and of high importance in homoeopathic totality, if found as a cause or existing along with main manifestation or alternating with other disease such as bronchial asthma etc. Similarly skin disease suppression by external application or even only by acute totality or sector totality selected homoeopathic medicine is considered of high important in miasmatic totality. This article deals with three cases where in one case skin eruption alternating with bronchial asthma and other case is having suppression of skin disease resulted to primary amenorrhoea. The last case is the case of an lady who had long back nose and its below area eruptions and subsequent ulcers suppressed by Nitric acid 10000CH caused the allergic conjunctivitis and skin allergies with lot of blackish discolurations and itching in whole body. The treatment methodology is adopted as per Hahnemann’s concept of treatment of chronic diseases i.e. Cessante causa, cessat effectus and Hering’s law of cure. The 1st case deals with Hering’s law of cure whereas 2nd case and 3rd case deals with Cessante causa, Cessat effectus. The three cases deals with practical part of taking acute totality and constitutional totality for total cure.

Evaluation of Clinical and Laboratory Findings in Hospitalized Children With SARS-CoV-2 Infection

Background: There are a few studies on the laboratory and clinical results of COVID-19 in pediatric patients. Objectives: The aim of the present study was to evaluate the laboratory and clinical findings of children who were hospitalized due to infection with COVID-19. Methods: This case-series study was conducted from May 1, 2020 to July 30, 2022 and evaluated hospitalized patients up to the age of 18 years old who were admitted with the diagnosis of COVID-19 infection in the endemic period of SARS-CoV-2 at Imam Ali hospital in Karaj. The required data were collected from medical records, including medical history, demographic information, SARS-CoV-2 symptoms, physical examination, laboratory test results, comorbidities, severity the of disease, and mortality rate. After obtaining the data, SPSS-26 was used to perform statistical analysis. Results: This study included 96 confirmed COVID-19 cases (42 females and 54 males), and the mean age of patients was 7.2 years. COVID-19 comorbidities were positive in 22 cases (22.9%), and diabetes was the most common comorbidity, which was detected in 13 cases (13.5%). Twelve (12.5%) cases of COVID-19 exhibited critical severity, and the mortality rate was 5.2%. The four most frequent clinical symptoms were found to be fever, cough, dyspnea, and vomiting, which were noted in 82 (85.4%), 52 (54.2%), 29 (30.2%), and 29 (30.2%) cases, respectively. In addition, respiratory distress and cyanosis were observed in 20 (20.8%) and 6 (6.3%) patients, respectively. Moreover, 18 (18.8%) cases had allergies, and skin allergies were the most prevalent, followed by allergic rhinitis and exercise-induced cough. Conclusion: This case series survey addressed the laboratory and clinical features of pediatric SARS-CoV-2 patients. Despite the relatively small number of samples, the findings could provide a useful report of the clinical manifestations and paraclinical findings of COVID-19 in children.

The Second Qatar Allergy and Immunology Conference: An Editorial.

The 2nd Qatar Allergy and Immunology Conference was organized by the Adult Allergy and Immunology Division of Hamad Medical Corporation (HMC) over two days as a hybrid conference on the 10th and 11th of February 2023 at ITQAN Clinical Simulation and Innovation Centre. The conference was preceded by two pre-conference workshops directed toward physicians and nurses on the 9th of February, 2023. The workshops aimed to promote awareness about allergic and immunologic diseases among physicians and nurses. The 2nd Qatar Allergy and Immunology Conference represented a great learning platform for healthcare professionals and opportunities to update knowledge, present research, and meet professionals since allergy and immunology practice is a rapidly evolving science focusing on allergic and immunologic conditions and their advanced treatment options. The conference’s scientific program focused on the following topics: airway allergy and asthma, skin allergies, diagnosis and management of primary immunodeficiency diseases, and novel therapeutics for allergic diseases. One of the significant achievements of this year’s conference is conducting a focused research symposium that provides a flagship platform for medical students and faculty scholars to present their research experiences and up-to-date health topics and to share their experiments and research findings with a broader community. It aimed to gather scientists and physicians from across Qatar and internationally with recent updates regarding the role of precision medicine in allergy and immunology science and practice. HMC supported the event in partnership with the Qatar Allergy and Immunology Society (QAIS) (a chapter of the Qatar Medical Association). It was accredited for 21.25 CPD Category 1 as defined by the Ministry of Public Health’s Department of Healthcare Professions. The conference hosted many expert speakers from Qatar, the Gulf region, and internationally. The total number of participants was 1082, comprised of physicians, nurses, and scientists. We received 34 abstracts, 32 were accepted for poster presentations, and the best six were selected for the oral presentation session. Another achievement of our conference is advocating the Arabic language. One lecture and one oral abstract were presented in Arabic to demonstrate the importance and simplicity of using the Arabic language in medical education and science.

A rare presentation of Sintilimab-induced swelling along the vessels: Case report.

Immune-related adverse events are occasionally reported in Sintilimab treatment. This study reports a forward and reverse swelling case along the vein after infusion of Sintilimab. At present, swelling along the vascular direction during peripheral infusion are limitedly reported at home and abroad, especially when choosing a vein with thick, elastic, and good blood return. A 56-year-old male who suffered from esophageal cancer and liver cancer and received albumin-bound paclitaxel and nedaplatin chemotherapy in combination with Sintilimab immunotherapy appeared swelling along the vessel after infusion of Sintilimab. The patient was punctured 3 times. Sintilimab-induced vascular edema may be a side effect resulted from a combination of variables such as relatively poor vascular function of the patient, chemical extravasation, allergic skin reactions, venous valves, vascular intima, and diameter stenosis. Sintilimab rarely causes vascular edema only when drug allergic reaction is the underlying factor. As only a few cases of vascular edema caused by Sintilimab have been reported, causes to such a drug-induced vascular edema remained unclear. The swelling was controlled by an intravenous specialist nurse according to delayed extravasation treatment and the doctor anti-allergy treatment, but the uncertainty of repeated puncture and symptom diagnosis caused pain and anxiety to the patient and his family. The symptom of swelling was gradually relieved after the anti-allergic treatment. The patient completed the following drug infusion without discomfort after the third puncture. When the patient was discharged the next day, swelling in his both hands disappeared, and the patient had no anxiety or discomfort. The side effects of immunotherapy may accumulate over time. Early identification and appropriate nursing management are the keys to minimizing patients' pain and anxiety. To effectively treat symptoms, nurses could benefit from quickly identifying the source of swelling.